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Prognostic Role of Preoperative Tricuspid Annular Plane Systolic Excursion (TAPSE) in mitral valve replacement (MVR) for Rheumatic mitral Stenosis Patients

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World Journal of Cardiovascular Surgery 2024年第8期14卷 115-130页

作者： Satyajit Sharma Muhit Abdullah Md. Noor-E-Elahi Mozumder Munjerin Refat Synthee Md. Zafar-Al-Nimari Anowarul Azim Saikat Das Gupta Dewan Iftakher Raza Chowdhury Siddhartha Shankar Howlader Noel Crypian Gomes Saleh Ahmed Samir Kumar Biswas Department of Cardiac Surgery National Heart Foundation Hospital & Research Institute (NHFH & RI) Dhaka Bangladesh Department of Cardiac Surgery National Institute of Cardiovascular Diseases & Hospital Dhaka Bangladesh Department of Cardiothoracic and Vascular Surgery Square Hospital Dhaka Bangladesh Department of Cardiothoracic and Vascular Surgery Evercare Hospital Chattogram Bangladesh

Tricuspid annular plane systolic excursion has been proposed as a simple and reproducible parameter for quantitative assessment of the right ventricular ejection fraction. The prognostic importance of preoperative TAPSE in patients with mitral valve replacement for rheumatic mitral stenosis patients is still under focused. Therefore, the objective of the study was to predict the outcome after MVR in rheumatic mitral stenosis patients in relation to preoperative TAPSE. This comparative cross-sectional study was conducted at the Department of Cardiac Surgery, National Heart Foundation Hospital and Research Institute. A total of 72 patients of rheumatic mitral stenosis patients who underwent mitral valve replacement were included in the study. They were divided into two groups: Group A and B. Group A included 36 patients with TAPSE 0.05) except for the preoperative TAPSE. Mean TAPSE of Group A was 13.17 (±1.40) and Group B was 18.61 (±1.57), the difference was statistically significant (p 0.05). Among the postoperative complications, including postoperative atrial fibrillation was higher in Group A (30.56%) than Group B (11.11%), mean ventilation time was higher in Group A (27.78%) than Group B (5.56%), length of intensive care was higher in Group A (33.33%) than Group B (11.12%), and hospital stay was higher in Group A (25.0%) than Group B (5.56%), (p mitral stenosis patients in our settings.

关键词： Tricuspid Annular Plane Systolic Excursion mitral valve replacement Rheumatic Heart Disease mitral Stenosis Right Ventricular Ejection Fraction Postoperative Complications

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Impact of prosthesis-patient mismatch on early and late outcomes after mitral valve replacement:a meta-analysis

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Journal of Geriatric Cardiology 2020年第8期17卷 455-475页

作者： Meng-Wei TAN Yi-Fan BAI Xiao-Hong LIU Zhi-Yun XU Zhao AN Ye MA Li-Bo ZHAO Bai-Ling LI Department of Cardiothoracic Surgery Changhai HospitalNaval Military Medical University(The Second Military Medical University)

Background Prognostic significance of prosthesis-patient mismatch(PPM)after mitral valve replacement(MVR)remains uncertain because of the limited studies reporting inconsistent or even contrary *** meta-analysis pooled results of all available studies comparing early and late prognoses between patients with significant mitral PPM and those *** Studies were identified by searching Pubmed,Excerpta Medica Database,Cochrane Central Register of Controlled Trials,and Clinical *** of PPM on postoperative hemodynamic results,thirty-day mortality,overall mortality,mortality of thirty-day survivors,and primary morbidity after MVR was evaluated via *** of pooled estimates,source of heterogeneity,and publication bias were assessed via sensitivity analyses,meta-regression as well as subgroup analysis stratified according to methodological or clinical heterogeneity,or sequential omission method,and funnel plot or Begg's and Egger's tests,*** Nineteen cohort studies involving 9302 individuals(PPM group:n=5109,Control group:n=4193)were included for *** PPM and severe PPM prevalence were 3.8%–85.9%and 1%–27%,with a mean value of 54.9%and 14.1%,*** compared with control group,mitral PPM group demonstrated a poorer postoperative hemodynamic status of higher mean and peak residual transprosthetic pressure gradients(TPG),higher postoperative systolic pulmonary artery pressure(SPAP)and less reduction,higher postoperative pulmonary hypertension(PH)prevalence and less PH regression,smaller net atrioventricular compliance,less NYHA class decrease,higher postoperative functional tricuspid regurgitation prevalence and less *** PPM group also revealed a higher thirty-day mortality,long-term overall mortality,mortality of thirty-day survivors,and postoperative congestive heart failure prevalence,which were positively correlated with the severity of PPM if it was classified into tri-le

关键词： Hemodynamics Meta-analysis mitral valve replacement Morbidity Mortality Prosthesis-patient mismatch

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Massive left atrial and interatrial septal calcification after mitral valve replacement

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Chinese Medical Journal 2008年第15期121卷 1497-1499页

作者： Yu-Shen Lin Feng-Chun Tsai Pao-Hsien Chu The First Cardiovascular Division Department of Internal Medicine Chang Gung Memorial Hospital Taipei Taiwan China Division of Thoracic & Cardiovascular Surgery Chang Gung Memorial Hospital Chang Gung University College of Medicine Taipei Taiwan China

Massive calcification of left atrium is an uncommon complication of long-standing rheumatic valvular disease, and is most often observed in patients with a previous operation on mitral valve. Most patients have experienced symptoms for more than 15 years. Massive calcification of the left atrium generality spared the interatrial septum in the previous studies. However, to our knowledge, fewer than five cases have presented as full left atrial calcification （Table）.

关键词： calcification left atrial interatrial septal mitral valve replacement

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Impact of prosthesis-patient mismatch on survival after mitral valve replacement： a systematic review

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Chinese Medical Journal 2013年第19期126卷 3762-3766页

作者： ZHANG Jian-feng WU Yi-cheng SHEN Wei-feng KONG Ye Department of Cardiac Surgery Shanghai Chest Hospital Shanghai Jiao Tong University Shanghai 200030 China Department of Cardiac Surgery Rui Jin Hospital School of Medicine Shanghai Jiao Tong University Shanghai 200025 China Department of Cardiology Rui Jin Hospital School of Medicine Shanghai Jiao Tong University Shanghai 200025 China

Objective To determine whether the prosthesis-patient mismatch has a deleterious impact on survival after mitral valve *** sources A comprehensive literature search of PubMed,Embase,and ScienceDirect was carried *** and cited papers of relevant articles were also *** selection All articles published after January 1980 was initially ***-English and non-human studies,case reports,and reviews were excluded from the initial *** and cited papers of relevant articles were also *** A total of 8 retrospective cohort studies were identified for this *** overall incidence of prosthesis-patient mismatch （〈1.3 to 〈1.2 cm2/m2） after mitral valve replacement ranged from 3.7% to 85.9% （moderate prosthesis-patient mismatch （0.9 to 1.2 cm2/m2） in 37.4% to 69.5%,severe prosthesis-patient mismatch （〈0.9 cm2/m2） in 8.7% to 16.4%）.Four studies demonstrated an association of prosthesis-patient mismatch with reduced long-term survival,but the other four studies found no significant deleterious impact of prosthesis-patient mismatch after mitral valve *** definite conclusion could be derived from these conflicting *** Current evidence is insufficient to derive a definite conclusion whether mitral prosthesis-patient mismatch affects long-term survival because of the biases and confounding factors that interfere with late clinical ***-quality prospective studies are warranted to evaluate the impact of mitral prosthesis-patient mismatch after mitral valve replacement in the future.

关键词： prosthesis-patient mismatch mitral valve replacement survival systematic review

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The Optimal Suture Technique for mitral valve replacement in an <i>Ex Vivo</i>Animal Model

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Open Journal of Thoracic Surgery 2021年第1期11卷 36-45页

作者： Emilie Schultz Hougaard Marie Schäfer Lars Peter Riber Department of Cardiac Thoracic and Vascular Surgery at Odense University Hospital Odense Denmark

Objective: This study compared and evaluated three suture methods in order to find the method with the best durability for mitral valve replacement. The methods evaluated are horizontal mattress suture with subanular pledgets, horizontal mattress suture with supraanular pledgets and continuous running suture. Methods: Thirty hearts were explanted from newly terminated pigs. The hearts were randomized in the three groups. After an atriotomy, the mitral valve was cut out, and a patch was sutured into its place. An air pump model was connected to a balloon which was placed in the left ventricle through aorta and continuously filled with air to a maximum of 300 mmHg. The peak pressure at rupture was noted. If no rupture occurred before reaching 300 mmHg, the suture was found competent. Results: Two out of ten hearts in the continuous running suture-group had myocardial rupture within a pressure of 300 mmHg. In the remaining eight hearts there were no ruptures within 300 mmHg. In the two groups sutured with horizontal mattress with pledgets placed either subanular or supraanular, no rupture of myocardium occurred. When comparing continuous running suture with the horizontal mattress with subanular pledgets or the horizontal mattress with supraanular pledgets, the 1-sided Fishers’ exact was 0.237. At 5% significance level, there was no difference between the three suture methods. Conclusion: There was no statistically significant difference between the durability of the three suture methods, though rupture was only evident in the continuous running suture line. Since it is the surgeon’s choice to select the optimal suture technique, our study should be a reminder for the surgeon to reflect on the suturing factors that have an influence on successful mitral valve replacement.

关键词： mitral valve mitral valve replacement Suture Technique

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Echocardiographic Monitoring of Cardiac Parameters after mitral valve replacement with the Preservation of Subvalvular Structures

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Chinese Medical Sciences Journal 2011年第1期26卷 64-68页

作者： Rasul Sadirhanovich Parpiyev Mirdjamal Mirumarovich Zufarov Khamidulla Amannullaevich Abdumadjivov Sayora Abdullaeva Khusan Gazihanovich Khalikulov Republic Specialized Center of Surgery Named after Academician V.Vahidov Tashkent Medical AcademyTashkent 100115Republic of Uzbekistan

To date many monitoring techniques have been used to determine the efficacy of surgical correction of mitral valve disease. The most common non-invasive method in use is echocardiography which can assess the myocardial and mitral valve function changes after mitral valve replacement procedures. In this study, we investigated the five-year follow-up echocardiographic results of 143 patients undergoing mitral valve replacement with preservation of subvalvular apparatus to analyze the recovery of myocardial and mitral valve functions.

关键词： echocardiography mitral valve replacement cardiac chamber size ventricular function

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Surgical incision in complete video-assisted mitral valve replacement

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South China Journal of Cardiology 2014年第2期15卷 99-105页

作者：张晓慎郭慧明刘菁曾庆诗雷迁谢斌李小辉 Department of Cardiovascular surgery Guangdong Cardiovascular Institute Guangdong General Hospital Guangdong Academy of Medical Sciences

Background Prosthetic mitral valve replacement is a common surgical treatment of mitral valve *** video-assisted mitral valve replacement represents the contemporary minimally invasive cardiac surgery in valve disease surgical therapy. In the field of minimally invasive cardiac surgery, the success of the operation is largely depending on surgical incision, it also reflects the surgeon’s technique level. Method From February 2010 to February 2013, 80 cases of cardiac patients with mitral valve pathological changes in our department who had received surgical treatment of complete video-assisted mitral valve replacement were recruited, they were divided into two groups according to the surgical incision： midclavicular group（M group,n = 50） and parasternal group（P group, n = 30）. The clinical data were recorded including： cardiopulmonary bypass time, aortic clamping time, volume of thoracic drainage after operation, ICU tracheal intubation time,postoperative days of hospital stay and time for observing the postoperative complications. The comparison between two groups was performed using t-test analysis. Result Both M Group and P Group had favorable surgical view, there were no emergency situation of redo median sternotomy during initial operative period or intraoperative death, no pericardial tamponade, no infection, and no other serious postoperative ***, there were 2 cases of redo operation for stanch bleeding in M Group and 1 case of perivalvular leakage in P Group. Nevertheless, 3 months later, the result of reexamine showed that the perivalvular leakage had vanished. The clinical data was shown as follow（M Group vs. P Group）： cardiopulmonary bypass time（90.2 ± 28.7 vs. 87.3 ± 24.5 min, P 〉 0.05）, aortic clamping time（65.2 ± 17.4 vs. 68.6 ± 21.9 min, P 〉 0.05）,1st day volume of thoracic drainage after operation 1（75.8 ± 35.6 vs. 53.2 ± 25.6 mL, P 〉 0.05）, ICU tracheal intubation time（9.6 ± 3.4 vs. 8.4 ± 4.5 hours, P 〉 0.05）, postoper

关键词： complete video-assisted cardiac surgery mitral valve replacement surgical incision

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Delayed papillary muscle rupture after radiofrequency catheter ablation: A case report

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World Journal of Clinical Cases 2021年第20期9卷 5556-5561页

作者： Ze-Wei Sun Bi-Feng Wu Xuan Ying Bi-Qi Zhang Lei Yao Liang-Rong Zheng Department of Cardiology Zhejiang UniversityHangzhou 310000Zhejiang ProvinceChina

BACKGROUND With an increased number of surgical procedures involving the mitral annular region,the risk of mitral valve prolapse(MVP)has also *** studies have reported that worsening of MVP occurred early after radiofrequency catheter ablation(RFCA)at papillary muscles in ventricular tachycardia(VT)patients with preoperative *** SUMMARY We report a case where MVP and papillary muscle rupture occurred 2 wk after RFCA in a papillary muscle originated VT patient without mitral valve regurgitation or prolapse *** patient then underwent mitral valve replacement with no premature ventricular contraction or *** the surgery,a papillary muscle rupture was *** examination showed necrosis of the papillary *** patient recovered after mitral valve *** Too many ablation procedures and energy should be avoided.

关键词： mitral valve prolapse Radiofrequency catheter ablation Ventricular tachycardia mitral valve replacement Dyspnea papillary muscles Case report

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Comparison between Doppler echocardiography and hot-film anemometry in measuring the turbulent shear stress downstream of artificial mitral valves： a methodological study

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Chinese Medical Journal 2013年第11期126卷 2174-2178页

作者： SUN Yi LI Rui-jie LI Gan-niu LI Bin WANG Yu MA Run-wei YANG Bai-hui LU Sen-lin ZHANG Gui-min Department of Cardiovascular Surgery First Affiliated Hospital of Kunming Medical University Kunming Yunnan 650031 China Department of Cardiology First Affiliated Hospital of Kunming Medical University Kunming Yunnan 650031 China College of Aerospace Engineering Nanjing University of Aeronauticsand Astronautics Nanjing Jiangsu 210016 China

Background Turbulent shear stress （TSS） plays an important role in the research of fluid dynamics of heart valves. This study aimed to perform a quantitative study of TSS downstream of porcine artificial mitral valves in order to verify the correlation of hot-film anemometry （HFA） and Doppler echocardiography combined with computer-aided image analysis for the detection of TSS. Methods A porcine model of mitral valve replacement was established. HFA and Doppler ultrasound techniques were used to directly and indirectly measure TSS-relevant parameters of the artificial mitral valve following different mitral valve replacements： different approaches were used to reserve the subvalvular apparatus of the mitral valve. A correlation analysis was then carried out. Results There was a significant correlation between the HFA and Doppler ultrasound combined with computer-aided image analysis of the TSS at the same time and at the same site. No significant difference was found in the TSS measured by the two methods. Conclusions Compared with HFA, Doppler echocardiography combined with computer-aided image analysis is a safe, non-invasive, and real-time method that enables accurate and quantitative detection of TSS downstream in vivo, objectively reflecting the flow field downstream of the artificial mitral valve. Doppler ultrasound combined with computer- aided image analysis can be employed for quantitatively evaluating the downstream hemodynamic performance of the mitral valve.

关键词： porcine mitral valve replacement turbulent shear stress Doppler echocardiography hot-film anemometry

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Cardioprotection of Shenfu Injection(参附注射液) against Myocardial Ischemia/Reperfusion Injury in Open Heart Surgery

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Chinese Journal of Integrative Medicine 2008年第1期14卷 10-16页

作者：郑传东闵苏 Department of Anesthesiology Sun Yat-sen University Tungwah HospitalDongguanGuangdong Province(523110)China Department of AnesthesiologyThe First Affiliated HospitalChongqing University of Medical SciencesChongqing(400016)China Department of Anesthesiology The First Affiliated HospitalChongqing University of Medical SciencesChongqing(400016)China

Objective： To investigate the protective effect of Shenfu Injection （参附注射液, SFI） against myocardium ischemia/reperfusion injury （IRI） in mitral valve replacement （MVR） with cardiopulmonary bypass （CPB）. Metheds： Forty patients undergoing selective MVR were randomly assigned to the control group and trial Groups Ⅰ, Ⅱ,Ⅲ, and Ⅳ according to the different administrations of SFI, 8 patients in each group. The changes of systolic blood pressure （SBP）, mean blood pressure （MBP）, diastolic blood pressure （DBP） in each group were monitored, respectively. The recovering percentage of spontaneous heart beat, the heart rate （HR） and cardiac rhythm as well as the abnormal duration of ECG-ST segment were recorded after the restoration of heart beat. The serum concentration of cardiac troponin Ⅰ （cTnl）, malondialdehyde （MDA） and the activity of superoxide dismutase （SOD） were determined as well. Results：（1） The SBP, MBP and DBP values, the recovering rate of spontaneous heart beat, HR, ECG-ST, atrioventricular block and ventricular arrhythmia were significantly improved in group Ⅳ compared with any other groups. （2） Compared with the control group, the postoperative serum contents of cTnl and MDA were significantly decreased, but the activity of SOD was significantly increased in group Ⅳ. Cenclusiens： SFI had a certain protective effect against myocardium IRI. Moreover, better efficacy was seen with the administration of 1.5 mL/kg SFI into CPB priming fluid and pumping 1.5 mL/kg SFI via CPB as soon as the clamped aorta was unclamped.

关键词： Shenfu Injection cardiopulmonary bypass mitral valve replacement myocardial protection ischemia/reperfusion injury

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